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Individual

JOHN A SELLING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
340 WILLOWBROOK DR, PORTOLA VALLEY, CA 94028-7842
(650) 743-0932
Mailing address
340 WILLOWBROOK DR, PORTOLA VALLEY, CA 94028-7842
(650) 743-0932

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
G046375
CA
207RG0100X
Gastroenterology Physician
Primary
G46375
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MMM00087M
NHIC
Enumeration date
04/12/2006
Last updated
01/21/2020
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